Lyme Disease During Pregnancy

Lyme disease can happen to anyone during the height of deer tick season in the spring and summer, but when you’re pregnant, getting diagnosed can be especially worrying.

In some parts of the country, deer ticks are out in droves in spring and summer and Lyme disease season is in full swing. When you're pregnant and spending time outside (and you should!), especially in grassy or woodsy areas, being bitten by a Lyme-carrying tick is a possibility, so it's important to know what to look for and what to do. And you may be wondering whether Lyme disease can affect your baby or look different during pregnancy.

Lyme disease is the most commonly reported vector-borne illness, meaning it’s transmitted by a tick, fly or mosquito. It’s more prevalent than West Nile, Dengue, Zika and Chikungunya fever. While anyone can be diagnosed, getting it during pregnancy is no fun. Luckily, it’s easily prevented — and if you do get it, it’s treatable and unlikely to affect your baby.

What is Lyme disease and how do I get it?

Lyme disease is a bacterial infection that’s caused by the bite of an infected black-legged tick (commonly known as a deer tick), which are most common during the spring and summer months. Most people are infected by “nymph” deer ticks, which are tiny, immature and hard to spot. While adult deer ticks can also carry the infection, they’re much more likely to be noticed and removed before the disease is transmitted. Deer ticks often attach to places that are difficult to see (like the groin, armpits and scalp). It usually takes 36 to 48 hours to transmit the disease.

The Centers for Disease Control and Prevention (CDC) estimates that 300,000 people get Lyme disease each year in the U.S., although 95 percent of those cases are mostly in the Northeastern and Midatlantic states — specifically Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia and Wisconsin. If you live in one of those regions or states, it's important to be especially vigilant.

More on Summer Health and Safety

Lyme Disease in Babies and Toddlers

How to Safely Protect Yourself from Mosquito Bites During Pregnancy

Sunscreen and Sun Protection During Pregnancy: What's Safe for My Baby and Me?

What are the symptoms of Lyme disease?

The signs and symptoms of Lyme disease are wide-ranging and get more serious if they go untreated for long periods of time. That’s why it’s always best to talk to your doctor or health care provider early on if you think you may have been infected.

Early symptoms

Red circular rash at the bite site that resembles a bull’s eye (it may get bigger or multiply the longer the infection remains untreated)

Is Lyme disease different when you're pregnant?

No, Lyme disease is not any different in pregnant women than it is in the general public. The symptoms and treatment are the same.

How can Lyme disease affect my baby?

Getting diagnosed with Lyme disease can be worrying when you’re not pregnant, but the idea of transmitting it to your baby-to-be can make you even more concerned. Luckily, doctors say that Lyme disease does not cause any additional risk to your pregnancy or the health of your little one. Borrelia burgdorferi, the bacteria that’s known to cause Lyme disease, isn’t normally transmitted from mother to unborn baby.

Infants born to mothers with Lyme disease do not require any additional treatment. While rare reports have shown that babies born to moms with Lyme have been diagnosed with heart defects, the research is inconclusive and unclear. Most doctors think that the reports are so rare that they may just be coincidences.

How can I safetly treat Lyme disease while I'm pregnant?

It bears repeating: Getting diagnosed early on is key so that the antibiotics can start to work on the disease and you can avoid the more serious later stage complications. Lyme disease can be safely treated when you’re pregnant with antibiotics like amoxicillin. While doxycycline is an effective treatment for Lyme disease, it is not considered safe during pregnancy. Azithromycin also may not be safe to take.

How can I protect myself and my baby from Lyme disease?

The best way to stop an infection is to prevent getting bitten in the first place and remove any ticks you do find on your body as soon as possible, since it takes 36 to 48 hours after you're bitten for the infection to be transmitted. Here are some tips for preventing tick bites:

Use tick repellents. If you're heading outside to a woodsy or grassy area, treat your clothing with 0.5 percent permethrin, an insect repellent that's particularly effective against tick bites. Apply DEET or picaridin repellent, both of which are safe during pregnancy, on any exposed skin.

Wear light clothing. Opt for long sleeves and pants tucked into your socks. Wearing light colors makes it easier to spot the dark body and legs of deer ticks.

Stay on trails. Try to avoid heavily wooded or leafy areas where ticks like to hide.

Dry your clothes immediately. Once you head inside, toss dry clothes in the drier on high heat for 10 minutes to kill ticks, longer if the clothes are damp.

Don't forget hidden areas. Tiny deer ticks can hide in the armpits, scalp and groin area, so have your partner, a relative or a friend do a tick check just in case.

Remove ticks using a cotton ball or tweezers. If you find a tick, soak a cotton ball in warm, soapy water and let it sit on your skin for 30 seconds. The tick should come off when you remove the cotton. Otherwise, grasp the tick with tweezers near your skin and pull firmly and steadily until it lets go (otherwise you might just remove the body). Rinse the bite site and apply an antibiotic cream.

Save the tick. Keep the body in a plastic bag so you can have your doctor check it for Lyme disease later.

Hop in the shower. Taking a warm shower within two hours of returning indoors has been shown to reduce the risk of tick-borne infection.

Is it Lyme disease or the flu?

The early symptoms of Lyme disease resemble those of the flu, but they’re not exactly the same. Flu symptoms include fever, muscle aches, sore throat, fatigue, runny nose, cough, nausea, vomiting and diarrhea. Lyme disease symptoms are different in that they include joint pain, swollen lymph nodes and headache in addition to fever and the chills.

One of the easiest ways to tell the flu and Lyme disease apart is the time of year. The flu is uncommon in the summertime, which is the time when Lyme disease is at its peak. If you start to feel feverish with joint aches and chills, especially if you’ve been spending ample time outside in tall grass or the woods, talk to your doctor. Another way to tell the difference is that 80 to 90 percent of those infected with Lyme disease get a rash (known as erythema migrans) that’s easy to recognize because it often resembles a bull’s eye.

According to the CDC, Lyme disease is normally diagnosed with a two-step lab test. The first step is called a “EIA” (enzyme immunoassay); if that comes back negative, then no more testing is done. If it’s positive, the second test, called a “Western blot” test, is done. If both tests come out positive, your doctor will start an antibiotic treatment for Lyme.

If you do notice Lyme disease-like symptoms at any point, talk to your doctor immediately. Even though the complications will likely not impact your pregnancy or your baby, they do worsen with time and can cause a lot of discomfort and long-term damage if the disease isn’t properly treated.

Lyme disease isn’t any fun, especially when you’re pregnant. But luckily, it is highly preventable. Use tick repellents and do tick checks after you’ve been in the woods, underbrush or grassy fields. If you do experience any of the symptoms listed above, don’t panic because the illness is totally treatable even during pregnancy. Take comfort in knowing that the chances you'll be infected by Lyme are very low, especially if you take the proper precautions.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You're Expecting. Health information on this site is based on peer-reviewed medical journals and highly respected health organizations and institutions including ACOG (American College of Obstetricians and Gynecologists), CDC (Centers for Disease Control and Prevention) and AAP (American Academy of Pediatrics), as well as the What to Expect books by Heidi Murkoff.

View Sources

What to Expect When You're Expecting, 5th edition, Heidi Murkoff and Sharon Mazel.